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Question

how cardiac output regulates central venous pressure?

Answer 1

We measured the changes in central venous pressure (CVP) and circulating blood volume (CBV) in dogs consequent to fluid infusion under halothane anesthesia, and compared the CVP and CBV responses to those obtained after blocking the autonomic nervous system by total spinal anesthesia (TSA) and stimulating the alpha receptor with methoxamine (MTX). Under TSA, the change in CVP consequent to fluid infusion was less than that under halothane anesthesia, while with MTX, the change in CVP was larger than that under halothane anesthesia. The recovery time of CVP response toward the baseline level after the end of fluid infusion was fastest under halothane anesthesia, while the recovery time of CVP was two times longer under TSA and MTX. Based on the relationship between changes in CVP and BV, we quantified effective vascular compliance and stress relaxation using mathematical analysis. The effective vascular compliance increased to 13.3 +/- 3.2 ml.mmHg-1.kg-1 under TSA as compared to 5.6 +/- 0.3 ml.mmHg-1.kg-1 under halothane anesthesia, and it decreased to 2.6 +/- 0.2 ml.mmHg-1.kg-1 with MTX. Stress relaxation was determined as the time constant in the unit response of CVP. The time constant for stress relaxation was 39 +/- 7 min under halothane, 74 +/- 12 min with TSA, and 92 +/- 25 min with MTX. These results suggest that the autonomic nervous system modifies cardiac preload by changing effective vascular compliance and stress relaxation.